| Prior statin use is associated with improved outcomes in community-acquired pneumonia. | |
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MedLine Citation:
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PMID: 18954848 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Statins have potent anti-inflammatory effects in laboratory studies of pulmonary inflammation. We investigated whether statin users had improved outcome when admitted with community-acquired pneumonia. METHODS: We carried out a prospective observational study of patients admitted to the hospital with community-acquired pneumonia between January 2005 and November 2007. The use of statins, angiotensin-converting enzyme inhibitors, beta-blockers, and aspirin were recorded. The outcomes of interest were 30-day mortality, need for mechanical ventilation or inotropic support, and the development of complicated pneumonia. RESULTS: On multivariate logistic regression, statin use was associated with significantly lower 30-day mortality (adjusted odds ratio [AOR] 0.46, 95% confidence interval [CI], 0.25-0.85, P=.01) and development of complicated pneumonia (AOR 0.44, 95% CI, 0.25-0.79, P=.006). There was no effect on requirement of mechanical ventilation or inotropic support (AOR 0.93, 95% CI, 0.49-1.76, P=.8). Patients prescribed statins had more severe pneumonia (median Pneumonia Severity Index 4, interquartile range [IQR] 3-4) compared with patients not prescribed cardiovascular drugs (median Pneumonia Severity Index 3, IQR 2-4, P < .0001). Despite this, C-reactive protein levels on admission were significantly lower in patients prescribed statins (median 119 mg/L, IQR 46-215) compared with patients prescribed no cardiovascular drugs (182 mg/L, IQR 66-326, P < .0001). On multivariate logistic regression, statin use was independently protective against a C-reactive protein that failed to fall by 50% or more at day 4 (AOR 0.50, 95% CI 0.27-0.92, P=.02). CONCLUSIONS: Statin use is associated with reduced markers of systemic inflammation and improved outcomes in patients admitted with community-acquired pneumonia. |
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Authors:
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James D Chalmers; Aran Singanayagam; Maeve P Murray; Adam T Hill |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The American journal of medicine Volume: 121 ISSN: 1555-7162 ISO Abbreviation: Am. J. Med. Publication Date: 2008 Nov |
Date Detail:
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Created Date: 2008-10-28 Completed Date: 2008-11-25 Revised Date: 2009-04-20 |
Medline Journal Info:
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Nlm Unique ID: 0267200 Medline TA: Am J Med Country: United States |
Other Details:
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Languages: eng Pagination: 1002-1007.e1 Citation Subset: AIM; IM |
Affiliation:
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Department of Respiratory Medicine, Royal Infirmary of Edinburgh, Edinburgh, Scotland, UK. jamesdchalmers@googlemail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over C-Reactive Protein / metabolism* Cardiovascular Diseases / drug therapy Community-Acquired Infections / complications, metabolism, mortality Confounding Factors (Epidemiology) Empyema, Pleural / etiology Female Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use* Male Middle Aged Pneumonia / complications, metabolism, mortality* Prospective Studies Respiration, Artificial Scotland / epidemiology |
| Chemical | |
Reg. No./Substance:
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0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 9007-41-4/C-Reactive Protein |
| Comments/Corrections | |
Comment In:
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Am J Med. 2009 May;122(5):e15; author reply e17
[PMID:
19375535
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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